Mental Health Services in Public Schools: A Preliminary Study of School Counselor Perceptions

By Carlson, Laurie A.; Kees, Nathalie L. | Professional School Counseling, April 2013 | Go to article overview

Mental Health Services in Public Schools: A Preliminary Study of School Counselor Perceptions


Carlson, Laurie A., Kees, Nathalie L., Professional School Counseling


This descriptive survey research study (N = 120) examined the self-reported comfort level of school counselors in addressing the mental health needs of their students and school counselor perceptions regarding working relationships with school-based therapists. Survey results indicated that school counselors are generally confident in their counseling skills and comfortable addressing common issues brought to them by their students. However, these same school counselors indicated that they experience some discomfort in working with students living with DSM diagnoses and that specific courses within counselor training programs may have a mitigating effect on this discomfort. Results also revealed that school counselors are willing to lead and work with cross-disciplinary teams and school-based therapists to better meet the mental health needs of their students.

Schools serve as the primary access or entry point for mental health services for youth through prevention, assessment, intervention, and referral processes (Alegria et al., 2012; Lever, Andrews, & Weist, 2008). As the mental health needs of school-age children increase (Perfect & Morris, 2011), community mental health services for youth are decreasing and underfunded, putting increased pressure on schools to address the mental health needs of students (Lockhart & Keys, 1998; Teich, Robinson, & Weist, 2007). Youth needing mental health services are more likely to access those services in a school setting than in a community-based mental health setting (Burnett-Zeigler & Lyons, 2010; Lever et al., 2008; Mellin, 2009). This is particularly true for students living in poverty, urban and minority youth, and rural youth where access to and utilization of mental health services is more likely with school-based programs (Cummings & Druss, 2011; Cummings, Ponce, & Mays, 2010; Mills et al., 2006). School counselors are on the front lines in providing those mental health services to youth, both through prevention and short-term intervention services and by identifying students with mental health needs, coordinating mental health teams, making appropriate referrals to mental health professionals, and following up on those referrals to ensure appropriate services are provided (Teich et al., 2007; Walley, Grothaus, & Craigen, 2009).

Mental health functioning is increasingly acknowledged as a vital component of effective learning and academic success for all students in schools (Kury & Kury, 2006) and essential to a comprehensive and holistic school counseling program (American School Counseling Association [ASCA], 2012). The 2003 President's New Freedom Commission on Mental Health's final report called for schools to play a greater role in addressing the mental health needs of children (Mills et al., 2006). Developing school-based mental health centers was one of the 19 recommendations of the national survey report, School Mental Health Services in the United States, 2002-2003 (Foster et al., 2005). Schools and communities are working toward addressing the mental health needs of students by creating school-based mental health centers (SBMHCs) and establishing collaborative mental health teams composed of school- and community-based mental health professionals (Kury & Kury, 2006; Mills et al., 2006). A 2004-2005 national study by the National Assembly on School-Based Health Care surveyed more than 1200 SBMHCs, with more than half of those in urban schools serving predominantly ethnic minority and low income students historically underserved for their mental health needs (Farahmand et al., 2011). One third of the SBMHCs surveyed in this study were in rural communities, again serving students and families with limited access to mental health services (National Assembly on School-Based Health Care, 2007).

The collaborative team approach of school-based mental health services includes, first and foremost, the student and the student's family, teachers, school counselors, social workers, nurses, and psychologists; and school-based and community-based mental health counselors, juvenile justice, and medical health professionals (Kury & Kury, 2006). …

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